Organization
CVS PHARMACY INC
Active
Other names
CVS PHARMACY # 11044
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1780 N LEE TREVINO DR, EL PASO, TX 79936-4522
(401) 765-1500
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1284731319
MEDICARE B
TX
05
—
471194
—
TX
01
—
5921336
NCPDP
TX
01
—
PH0708
MASS IMM
TX
Enumeration date
04/27/2017
Last updated
10/25/2017
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